Prehospital and Disaster Medicine最新文献

{"title":"Early Vital Sign Thresholds Associated with 24-Hour Mortality among Trauma Patients: A Trauma Quality Improvement Program (TQIP) Study.","authors":"Michael D April, Andrew D Fisher, Julie A Rizzo, Franklin L Wright, Julie M Winkle, Steven G Schauer","doi":"10.1017/S1049023X24000207","DOIUrl":"10.1017/S1049023X24000207","url":null,"abstract":"<p><strong>Background: </strong>Identifying patients at imminent risk of death is critical in the management of trauma patients. This study measures the vital sign thresholds associated with death among trauma patients.</p><p><strong>Methods: </strong>This study included data from patients ≥15 years of age in the American College of Surgeons Trauma Quality Improvement Program (TQIP) database. Patients with vital signs of zero were excluded. Documented prehospital and emergency department (ED) vital signs included systolic pressure, heart rate, respiratory rate, and calculated shock index (SI). The area under the receiver operator curves (AUROC) was used to assess the accuracy of these variables for predicting 24-hour survival. Optimal thresholds to predict mortality were identified using Youden's Index, 90% specificity, and 90% sensitivity. Additional analyses examined patients 70+ years of age.</p><p><strong>Results: </strong>There were 1,439,221 subjects in the 2019-2020 datasets that met inclusion for this analysis with <0.1% (10,270) who died within 24 hours. The optimal threshold for prehospital systolic pressure was 110, pulse rate was 110, SI was 0.9, and respiratory rate was 15. The optimal threshold for the ED systolic was 112, pulse rate was 107, SI was 0.9, and respiratory rate was 21. Among the elderly sub-analysis, the optimal threshold for prehospital systolic was 116, pulse rate was 100, SI was 0.8, and respiratory rate was 21. The optimal threshold for ED systolic was 121, pulse rate was 95, SI was 0.8, and respiratory rate was 21.</p><p><strong>Conclusions: </strong>Systolic blood pressure (SBP) and SI offered the best predictor of mortality among trauma patients. The SBP values predictive of mortality were significantly higher than the traditional 90mmHg threshold. This dataset highlights the need for better methods to guide resuscitation as initial vital signs have limited accuracy in predicting subsequent mortality.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"151-155"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140336647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Medical Services Protocols for Assessment and Treatment of Patients with Ventricular Assist Devices.","authors":"Emily L Larson, JiWon Woo, Gyeongtae Moon, Kathy Liu, Matthew Vergel, Reed Jenkins, Kelly Jiang, Zachary Darby, Asa Margolis, Ahmet Kilic","doi":"10.1017/S1049023X2400013X","DOIUrl":"10.1017/S1049023X2400013X","url":null,"abstract":"<p><strong>Background: </strong>Patients with ventricular assist devices (VADs) represent a growing population presenting to Emergency Medical Services (EMS), but little is known about their prehospital care. This study aimed to characterize current EMS protocols in the United States for patients with VADs.</p><p><strong>Methods: </strong>States with state-wide EMS protocols were included. Protocols were obtained from the state EMS website. If not available, the office of the state medical director was contacted. For each state, protocols were analyzed for patient and VAD assessment and treatment variables.</p><p><strong>Results: </strong>Of 32 states with state-wide EMS protocols, 21 had VAD-specific protocols. With 17 (81%) states noting a pulse may not be palpable, protocols recommended assessing alternate measures of perfusion and mean arterial pressure (MAP; 15 [71%]). Assessment of VAD was advised through listening for pump hum (20 [95%]) and alarms (20 [95%]) and checking the power supply (15 [71%]). For treatment, EMS prehospital consultation was required to begin chest compression in three (14%) states, and mechanical (device) chest compressions were not permitted in two (10%) states. Contact information for VAD coordinator was listed in a minority of five (24%) states. Transport of VAD equipment/backup bag was advised in 18 (86%) states.</p><p><strong>Discussion: </strong>This national analysis of EMS protocols found VAD-specific EMS protocols are not universally adopted in the United States and are variable when implemented, highlighting a need for VAD teams to partner with EMS agencies to inform standardized protocols that optimize these patients' care.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"136-141"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interorganizational Knowledge Transfer in Mass Gatherings: Exploring the Health and Safety Stakeholders' Perceptions Participating in the Athens Marathon.","authors":"Angeliki Bistaraki, Nikos Stefanopoulos","doi":"10.1017/S1049023X24000219","DOIUrl":"10.1017/S1049023X24000219","url":null,"abstract":"<p><strong>Introduction: </strong>Mass gatherings (MGs) usually represent significant challenges for the public health and safety sector of the host cities. Organizing a safe and successful mass event highly depends on the effective collaboration among different public and private organizations. It is necessary to establish successful coordination to ensure that all the key stakeholders understand their respective roles and responsibilities. The inconsistency between the variety of participating agencies because of their different culture can result in delays in decision making. Interorganizational knowledge transfer can improve the success of the event; however, knowledge transfer among professionals and agencies in MGs is not well-documented.</p><p><strong>Objective: </strong>This study used the 2018 Athens Marathon as the empirical setting to examine how interorganizational knowledge transfer was perceived among the multiple public health and safety professionals during the planning stage of the event.</p><p><strong>Methods: </strong>Data comprised 18 semi-structured, in-depth interviews with key informants, direct observations of meetings, and documentary analysis. Open coding and thematic analysis were used to analyze the data.</p><p><strong>Results: </strong>Findings indicated that sharing the acquired knowledge was a necessary and challenging step to create an enabling collaborative environment among interacting organizations. Experiential learning was identified as a significant factor, which helped promote joint understanding and partnership work. Informal interpersonal exchanges and formal knowledge transfer activities facilitated knowledge sharing across organizational boundaries, helping to break down silos.</p><p><strong>Conclusion: </strong>Interorganizational knowledge transfer is a necessary step to achieve joint understanding and create an environment where interaction among agencies can be more effective. The study findings can be beneficial for organizers of marathons and other mass sporting events to support valuable interorganizational collaboration and conduct a safe event.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"163-169"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11035917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140132391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disaster Preparedness and Safety Curriculum for Early Childhood Education in Indonesia.","authors":"Rizky Andana Pohan, Erfan Ramadhani, Marimbun Marimbun, Wan Chalidaziah, Nengsih Nengsih, Marhaban Marhaban","doi":"10.1017/S1049023X24000177","DOIUrl":"10.1017/S1049023X24000177","url":null,"abstract":"<p><strong>Background: </strong>Indonesia is located within the Asia-Pacific Ring of Fire, so natural disasters such as earthquakes, tsunamis, volcanic eruptions, floods, and landslides are common. Preparedness is essential to prevent many casualties due to various disasters.</p><p><strong>Problem: </strong>The Aceh, Indonesia earthquake and tsunami in 2004 was one of the most devastating disasters since the 1990s. Some of the victims were children. This is because there was no pattern of preparedness in dealing with disasters when the incident took place; even the word tsunami was not familiar in Indonesia at that time. Thus, the preparation of a disaster preparedness and safety curriculum began to be implemented in Indonesia after the Aceh earthquake and tsunami.</p><p><strong>Conclusion: </strong>The disaster preparedness and safety curriculum in early childhood education is developed in accordance with the potential and characteristics of the school area. Basic disaster material provided concepts, characteristics and threats, maps, ways of overcoming, and disaster preparedness and security. Facilities and infrastructure supporting disaster preparedness learning used disaster puzzles, disaster posters, songs about disasters, and prayers asking God for help to be protected from disasters.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"228-229"},"PeriodicalIF":2.1,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140060300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Evaluation of Earthquake Victims Followed Up in the Intensive Care Unit After the 2023 Turkey Kahramanmaras Earthquakes","authors":"Sinem Berik Safçi, Esra Aybal, Özlem Erçen Diken","doi":"10.1017/s1049023x24000190","DOIUrl":"https://doi.org/10.1017/s1049023x24000190","url":null,"abstract":"<span>Introduction and Study Objective:</span><p>In Turkey, a total of 269 earthquakes took place from 1900 through 2023. The most devastating earthquakes in terms of casualties and extensive destruction occurred at 4:17<span>am</span> and 1:24<span>pm</span> local time on February 6, 2023 with the epicenters located in Pazarcik (Kahramanmaras) and Ekinozu (Kahramanmaras) and magnitudes of 7.7Mw and 7.6Mw, respectively. The aim of this study was to define the frequency of lung complications that occurred directly and/or developed during the intensive care follow-up of individuals affected by the Kahramanmaras earthquakes.</p><span>Method:</span><p>A retrospective evaluation was conducted on the files of 69 patients who were rescued from the debris of collapsed buildings after the Kahramanmaras earthquakes and followed up in the intensive care unit in terms of the time under the debris, demographic data, vital signs, and lung complications that were present at the time of admission and developed during follow-up. SPSS for Windows v. 20.0 was used for data analysis.</p><span>Results:</span><p>The study included a total of 69 patients, of whom 29 (42%) were female and 40 (58%) were male. The mean age was 39.9 (SD = 16.9) years. The mean time under the debris was 53.9 (SD = 52) hours, and the mean time from rescue to the intensive care unit admission was 18.7 (SD = 12.8) hours. One or more pulmonary complications were detected in 52.2% (n = 36) of the patients at the time of admission. During the follow-up, 30.4% (n = 21) of the patients developed pulmonary congestion, 13.0% (n = 9) pneumonia, 1.5% (n = 1) alveolar hemorrhage, and 1.5% (n = 1) atelectasis, while no additional lung complications developed in the remaining 37 patients (53.6%).</p><span>Conclusion:</span><p>Severe cases of individuals recovered from the debris can have a high prevalence of earthquake-related lung disorders and chest trauma, which may be associated with high mortality. The timely identification and effective intervention of pulmonary complications that may develop during follow-up can reduce mortality.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"5 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140170928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of META and SALT Disaster Triage in an Adult Trauma Population: A Retrospective Observational Study","authors":"Gawin Tiyawat, J. Marc Liu, Thongpitak Huabbangyang, Cesar Luis Roza-Alonso, Rafael Castro-Delgado","doi":"10.1017/s1049023x24000098","DOIUrl":"https://doi.org/10.1017/s1049023x24000098","url":null,"abstract":"<span>Background:</span><p>Medical professionals can use mass-casualty triage systems to assist them in prioritizing patients from mass-casualty incidents (MCIs). Correct triaging of victims will increase their chances of survival. Determining the triage system that has the best performance has proven to be a difficult question to answer. The Advanced Prehospital Triage Model (Modelo Extrahospitalario de Triaje Avanzado; META) and Sort, Assess, Lifesaving Interventions, Treatment/Transport (SALT) algorithms are the most recent triage techniques to be published. The present study aimed to evaluate the META and SALT algorithms’ performance and statistical agreement with various standards. The secondary objective was to determine whether these two MCI triage systems predicted patient outcomes, such as mortality, length-of-stay, and intensive care unit (ICU) admission.</p><span>Methods:</span><p>This retrospective study used patient data from the trauma registry of an American College of Surgeons Level 1 trauma center, from January 1, 2018 through December 31, 2020. The sensitivity, specificity, and statistical agreement of the META and SALT triage systems to various standards (Revised Trauma Score [RTS]/Sort Triage, Injury Severity Score [ISS], and Lerner criteria) when applied using trauma patients. Statistical analysis was used to assess the relationship between each triage category and the secondary outcomes.</p><span>Results:</span><p>A total of 3,097 cases were included in the study. Using Sort triage as the standard, SALT and META showed much higher sensitivity and specificity in the Immediate category than for Delayed (Immediate sensitivity META 91.5%, SALT 94.9%; specificity 60.8%, 72.7% versus Delayed sensitivity 28.9%, 1.3%; specificity 42.4%, 28.9%). With the Lerner criteria, in the Immediate category, META had higher sensitivity (77.1%, SALT 68.6%) but lower specificity (61.1%) than SALT (71.8%). For the Delayed category, SALT showed higher sensitivity (META 61.4%, SALT 72.2%), but lower specificity (META 75.1%, SALT 67.2%). Both systems showed a positive, though modest, correlation with ISS. For SALT and META, triaged Immediate patients tended to have higher mortality and longer ICU and hospital lengths-of-stay.</p><span>Conclusion:</span><p>Both META and SALT triage appear to be more accurate with Immediate category patients, as opposed to Delayed category patients. With both systems, patients triaged as Immediate have higher mortality and longer lengths-of-stay when compared to Delayed patients. Further research can help refine MCI triage systems and improve accuracy.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"23 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139968964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Doppler Ultrasonography and Computerized Tomography Angiography in Emergency Department Evaluation of Earthquake-Related Crush Injuries: A Case Series Analysis","authors":"Remzi Cetinkaya, Mehmet Ozel, Ali Cankut Tatliparmak, Sarper Yılmaz, Rohat Ak","doi":"10.1017/s1049023x24000086","DOIUrl":"https://doi.org/10.1017/s1049023x24000086","url":null,"abstract":"<span>Objective:</span><p>This case series aims to provide a comprehensive description of the utilization of doppler ultrasonography (USG) and computerized tomography angiography (CTA) in evaluating patients with earthquake-induced crush injuries in the emergency department (ED).</p><span>Methods:</span><p>This retrospective case series was conducted on 11 patients who presented with crush injuries following a seismic event. These patients underwent initial assessment using doppler USG, with CTA performed when deemed necessary. Clinical outcomes and diagnostic findings were systematically reviewed.</p><span>Results:</span><p>A cohort of 11 earthquake-related crush injury patients (six females, five males; age 3-59 years), predominantly with lower extremity injuries, with entrapped durations that ranged from 12 to 128 hours. Transport centers received patients from both affected regions and nearby provinces. Initial X-rays identified fractures in two cases. Doppler USG and subsequent CTA were employed for vascular evaluation, with CTA confirming doppler USG findings. Of the 11 patients, five exhibited abnormal doppler USG findings. Four patients required dialysis and four underwent amputation surgery. Fasciotomy and debridement procedures were performed in five and seven patients, respectively. Three patients received hyperbaric oxygen therapy (HBOT).</p><span>Conclusion:</span><p>Doppler USG emerged as a dependable tool for assessing vascular injuries in earthquake-related crush injuries, offering an effective alternative to CTA without the associated contrast agent risks. These findings underscore the need for further research to establish definitive imaging guidelines in these challenging clinical scenarios.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":"78 1","pages":""},"PeriodicalIF":2.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139968970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Footprint of Emergency Medicine Physicians in Disaster Medicine Publications: A Bibliometric Analysis.","authors":"Nurcan Biçakçi, Sercan Biçakçi","doi":"10.1017/S1049023X23006738","DOIUrl":"10.1017/S1049023X23006738","url":null,"abstract":"<p><strong>Introduction: </strong>Investigating the developments in the ever-growing field of disaster medicine and revealing the scientific trends will make an important contribution to researchers in related fields. This study aims to identify the contributions of emergency medicine physicians (EMPs) and trends in disaster medicine publications.</p><p><strong>Methods: </strong>The expressions \"disaster medicine\" or \"disaster*\" and \"medicine*\" were searched in the Web of Science (WoS) database. Research and review papers produced by EMPs from 2001 through 2021 were included in the study. Basic descriptive information was assessed such as the number of publications, authors, citations, most active authors, institutions, countries, and journals. In addition, conceptual, intellectual, and social structures were analyzed.</p><p><strong>Results: </strong>The study included a total of 346 papers written by 1,500 authors. The mean citation rate per publication was 13.2. <i>Prehospital and Disaster Medicine</i>, <i>Disaster Medicine and Public Health Preparedness</i>, and <i>Academic Emergency Medicine</i> were the journals with the highest number of publications and the highest number of citations. The most common keywords used by the authors were \"disaster medicine,\" \"emergency medicine,\" and \"disaster/disasters.\" According to the distribution of the corresponding authors by country, the United States (n = 175), Japan (n = 23), Italy (n = 20), Australia (n = 17), and Canada (n = 17) had the highest number of publications. The institutions that produced the most publications were John Hopkins University (n = 37), Brigham and Women's Hospital (n = 27), George Washington University (n = 25), University Piemonte Orientale (n = 24), and Brown University (n = 22).</p><p><strong>Conclusion: </strong>Increasingly, EMPs have contributed to disaster medicine publications over the years. This study can be used as a guide for EMPs and other researchers who want to contribute to the disaster medicine literature.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"13-19"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr. Judith Fisher.","authors":"Samuel J Stratton","doi":"10.1017/S1049023X24000013","DOIUrl":"10.1017/S1049023X24000013","url":null,"abstract":"","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"1-2"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139491801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redesigning Prehospital Care: Fiji's Response to the COVID-19 Pandemic.","authors":"Anne Creaton, Ilikini Naitini, Lemecki Lenoa","doi":"10.1017/S1049023X24000037","DOIUrl":"10.1017/S1049023X24000037","url":null,"abstract":"<p><p>The benefits of emergency care systems in low- and middle-income countries are well-described. Passed in the wake of the coronavirus disease 2019 (COVID-19) pandemic, the World Health Assembly (WHA) Resolution 76.2 emphasizes the importance of communication, transportation and referral mechanisms, and the linkages between communities, primary care, and hospital care. Literature describing prehospital care and ambulance system development is scarce, with little data on the effectiveness and cost effectiveness of different options. Prehospital care systems in Pacific Island countries are under-developed. In Fiji, out-of-hospital care is fragmented with an uncoordinated patchwork of ambulance providers. There is no scope of practice or training requirement for providers and no patient care records. There are no data relating to demand, access, and utilization of ambulance services.In response to a surge of COVID-19 cases in 2021, the Fiji government created a Prehospital Emergency Care Coordination Center (PHECCC) in the capital Suva, which was operational from July-October 2021. Access was via a toll-free number, whereby the public could receive a medical consultation followed by phone advice or dispatch of an ambulance for a home assessment, followed by transportation to hospital, if required. The PHECCC also provided coordination of inter-facility transport and retrieval of the critically ill.The system that was created met many of the prehospital care standards set by emergency care leaders in the region and created the first dataset relating to ambulance demand and utilization. This is the first article to document prehospital system development in the Pacific region.</p>","PeriodicalId":20400,"journal":{"name":"Prehospital and Disaster Medicine","volume":" ","pages":"106-110"},"PeriodicalIF":2.2,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10882555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139571115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}